This environmental assessment for the Vietnam HIV/AIDS Prevention Project focuses on the risks posed by health care waste at rehabilitation centers. Possible pathways to infection include: Direct contact, contact through vectors (flies, rodents, animals... See More +This environmental assessment for the Vietnam HIV/AIDS Prevention Project focuses on the risks posed by health care waste at rehabilitation centers. Possible pathways to infection include: Direct contact, contact through vectors (flies, rodents, animals), airborne transmission; the pollution of water sources, especially in the medical centers where tap water is not available or dug wells or the local environment is used; through contact with the hazardous healthcare waste. These risks can be reduced by: Efficient separation from the waste stream at the point of generation; disinfection before disposal, e.g. chemical treatment, steam/heat treatment; incineration particularly through using a cluster incinerator; providing personal protective equipment e.g. heavy duty gloves, safety glasses, thick clothes; designing systems to minimize contact, e.g. good onsite storage, bagging of waste, use of boxes to store waste sharps, more effective transportation or trolleys, no putting clinical waste into domestic waste bin without lids; restricting access to healthcare waste dumping site; improving awareness of risks; applying vector control methods e.g. covering waste; protecting water supplies from contamination; implementing good hygiene practices when dealing with waste e.g. hand washing; creating a dedicated budget line for waste management; implementing final disposal by effective sanitary landfill; immunizing those in contact with healthcare waste against certain diseases e.g. Hepatitis B and tetanus; providing better access to healthcare for those in contact with waste e.g. in order to stop infections from deteriorating; and providing rehabilitation centers with enough equipment and analytical to detect the HIV positive trainees having tuberculosis or Hepatitis B so that they can protect them and protect others from contamination.
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